Psoriasis Patients At Higher Risk for Multiple Pathological Fractures

MedicalResearch.com Interview with:
Dr. Jonathan L. Silverberg MD PhD MPH

Assistant Professor in Dermatology
Medical Social Sciences and Preventive Medicine
Northwestern University, Chicago, Illinois

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois

Dr. Jonathan Silverberg

Response: Psoriasis is associated with a number of potential risk factors for developing osteoporosis and pathological fractures, including including low vitamin D, chronic inflammation, higher rates of cigarette smoking and systemic corticosteroid usage. We hypothesized that adults with psoriasis have higher rates of osteoporosis and pathological fractures.

We examined data from the 2002-2012 National Inpatient Sample, which contains a representative 20% sample of all hospitalizations in the United States. We found that psoriasis was associated with higher odds of osteopenia, osteoporosis, osteomalacia, ankylosing spondylitis, and pathological fractures. In particular, psoriasis was associated with vertebral, pelvic, femoral and tibial/fibular fractures. The associations between psoriasis and pathological fractures were more pronounced in women than men.

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Poorly Controlled Atopic Dermatitis Causes Significant Inpatient Financial Burden

MedicalResearch.com Interview with:

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois

Dr. Jonathan Silverberg

Dr. Jonathan L. Silverberg MD PhD MPH
Assistant Professor in Dermatology
Medical Social Sciences and Preventive Medicine
Northwestern University, Chicago, Illinois 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Atopic dermatitis (AD) is associated with considerable morbidity and quality of life impairment. AD patients may require hospitalization for acute treatment of serious flares and/or inadequately controlled chronic disease.

We examined data from the 2002-2012 National Inpatient Sample, which contains a representative 20% sample of all hospitalizations in the United States. We found that there were substantial numbers of children and adults hospitalized in the United States for AD. Hospitalization rates for atopic dermatitis were highest in the northeast during the winter likely due to cold and dry weather and south during the summer likely due to heat and humidity. Further, hospitalization rates for AD significantly increased in adults between 2002 and 2012. The costs per individual hospitalization were lower in children and adults with AD compared to those without  atopic dermatitis. However, the high prevalence of hospitalization resulted in total inpatient costs of >$8 and >$3 million per-year for adults and children, respectively.

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Development and Assessment of BPX-01, a Novel Topical Minocycline Gel for Treatment of Acne Vulgaris


MedicalResearch.com Interview with:
Usha Nagavarapu, PhD

Senior director of preclinical drug development
BioPharmX

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Acne vulgaris is a complex chronic inflammatory disease known to be linked with P. acnes and can have profound social and psychological effects. Though a number of treatments exist, there is promise of a long-term benefit for acne patients. BioPharmX’s in vitro and in vivo studies have revealed that a low-dose, topical 1% minocycline gel (BPX-01) provided a localized and targeted delivery of adequate minocycline to the epidermis and pilosebaceous units that can potentially limit systemic exposure and may reduce treatment related side effects.

At the intended clinical dose, toxicity and safety animal studies found that BPX-01 was well tolerated with no significant local or systemic toxic effects. A comparative animal study with oral minocycline demonstrated that topical application of minocycline can limit systemic exposure while delivering sufficient minocycline to the skin to treat acne vulgaris.

Along the same lines, a 4-week clinical study with extended release oral minocycline to assess the skin and plasma concentrations of minocycline was conducted. A marked reduction of mean acne lesion counts from baseline was seen with oral minocycline with presence in plasma. On the contrary no minocycline was identified in the skin from periauricular biopsies.

Recently, BioPharmX completed a 4-week Phase 2 clinical repeat-dose study of BPX-01. The minocycline gel was well tolerated and over 90% of P. acnes were eliminated.

A 12-week Phase 2 dose-finding clinical trial to further assess the efficacy and safety of BPX-01 for the treatment of moderate-to-severe, non-nodular inflammatory acne vulgaris has been initiated. The dose-finding study will provide additional support for the planned Phase 3 clinical trial program with BPX-01.

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Curcumin Gel May Speed Healing of Scalds and Burns

MedicalResearch.com Interview with:

Madalene Heng MD, FRACP, FACD, FAAD</strong> Professor of Medicine/Dermatology UCLA School of Medicine

Dr. Madalene Heng

Madalene Heng MD, FRACP, FACD, FAAD
Professor of Medicine/Dermatology
UCLA School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Curcumin, the active ingredient in the spice, turmeric, is an excellent anti-inflammatory agent with unique healing properties.

However, this is only observed with our preparation of topical curcumin but not with oral curcumin. This is because curcumin is not absorbed and does not cross cell membranes – low bioavailability.

The biochemical basis for the efficacy of topical curcumin is based on the fact that it is a phosphorylase kinase inhibitor. Phosphorylase kinase is an enzyme released by injured tissue 5 mins following injury, and is responsible for activating the transcription activator (NF-kB), resulting in turning on over 200 genes responsible for inflammation, and scarring among others, resulting in redness, swelling, pain, and eventually scarring. By blocking phosphorylase kinase activity early in the injury pathway, topical curcumin (curcumin gel) results in rapid healing with minimal or no scarring following many types of healing, including burns and scalds. The unique healing properties are also due to the fact that curcumin induces cell death (apoptosis) to damaged cells, resulting in the “space” for replacement by new healthy cells, resulting in normal appearing skin following burns and scalds.

The salutary result depends on when the curcumin gel is applied – the earlier the better. We observed that when curcumin gel was applied within 4 days to second degree burns- hourly applications, tapering after the patient is improved – we observed rapid healing within 5 days, with the skin returning to normal within 6 weeks to 2 months without redness or visible scarring. Minor burns and scalds heal even more rapidly. Pain was improved within hours.

MedicalResearch.com: What should readers take away from your report?

Response: If the readers happen to have curcumin gel (Psoria-Gold) in their first aid kit, they should apply curcumin gel multiple times as soon as possible. Within the first hour, they should apply it every 5-10 mins, tapering off when the pain and swelling is improved. If they do this, it is possible that blistering may be aborted. The scarring is also minimal. The curcumin gel should be applied twice daily until the skin returns to normal (no redness, swelling, pigmentation etc) and no visible scarring is seen.

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Dermatology Physician Assistants Helping To Supplement Care in Underserved Areas

MedicalResearch.com Interview with:
Dr. Alex M. Glazer MD
National Society for Cutaneous Medicine
New York, New York 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We had previously studied the geographic distribution of dermatologists throughout the United States which revealed that dermatologists are unevenly geographically distributed throughout the country, with many regions having fewer than the 4 providers per 100,000 people needed to adequately care for a population. Because of the influx of PAs and NPs into the healthcare workforce throughout the past decade, we wanted to see how these providers were supplementing dermatologic care.

The main finding of our study is that dermatology PAs are helping to supplement dermatologists and together are providing broader, more uniform coverage across the United States

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High Schools Less Likely To Adopt Sun Safety Practices

MedicalResearch.com Interview with:

Sherry Everett Jones PhD, MPH, JD, FASHA Health Scientist, Division of Adolescent School Health Centers for Disease Control & Prevention

Dr. Sherry Everett Jones

Sherry Everett Jones PhD, MPH, JD, FASHA
Health Scientist, Division of Adolescent School Health
Centers for Disease Control & Prevention

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Skin cancer is the most common form of cancer in the United States. Results from the School Health Policies and Practices Study found that in 2014, most schools lacked practices that could protect children and adolescents from sun exposure while at school. Positive attitudes and beliefs about sun safety behavior, which would make such behavior more likely, can be promoted and supported by school system policies and practices.

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Prenatal Tobacco Smoke Raises Risk of Atopic Dermatitis in Offspring

MedicalResearch.com Interview with:

Dr. Saskia Trump PhD Helmholtz-Centre for Environmental Research – UFZ Department of Environmental Immunology Leipzig, Germany

Dr. Saskia Trump

Dr. Saskia Trump PhD
Helmholtz-Centre for Environmental Research – UFZ
Department of Environmental Immunology
Leipzig, Germany

MedicalResearch.com: What is the background for this study?

Response: Environmental chemicals have long been discussed to contribute to the exacerbation or even the development of allergic diseases. In our study we were particularly interested in the effect of tobacco smoke exposure, which is the main source for indoor benzene exposure, on regulatory T cell (Treg) function and its relation to the development of childhood atopic dermatitis (AD). Tregs play a critical in controlling T effector cell activity by avoiding overexpression. A deficiency in this T cell subset increases the risk for allergic inflammation.

We have previously described that exposure to tobacco smoke during pregnancy can decrease the number of regulatory T cells (Treg) in the cord blood and predispose the child to the development of AD (1). In this subsequent study we were interested in the underlying mechanism involved.

Benzene itself is not considered to be toxic, however its metabolization leads to the formation of highly reactive molecules. In humans for example the metabolite 1,4-benzochinone (1,4-BQ) can be found in the blood as a consequence of benzene exposure.

To further assess the effect of benzene on Treg and the development of AD we combined in vitro studies, evaluating the impact of 1,4-BQ on human expanded Treg, with data from our prospective mother-child cohort LINA. The LINA study, recruited in Leipzig, Germany, is a longitudinal evaluation of mother-child pairs with respect to lifestyle and environmental factors that might contribute to disease development in the child. Based on this deeply phenotyped cohort we were able to translate our in vitro findings to the in vivo scenario.

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Taltz Demonstrates Improved Clearing of Psoriasis Compared to Stelara

MedicalResearch.com Interview with:

Prof. Dr. Kristian Reich, Dermatologikum Hamburg, Hamburg 07.04.2009 | Prof. Dr. Kristian Reich, Dermatologikum Hamburg, Hamburg, Germany, 07.04.2009 | [© (c) Martin Zitzlaff, Emilienstr.78, 20259 Hamburg, Germany, Tel. +491711940261, http://www.zitzlaff.com, martin@zitzlaff.com, Postbank Hamburg BLZ 20010020 Kto.-Nr. 10204204, MwSt. 7%, Veroeffentlichung nur gegen Honorar (MFM) und Belegexemplar, mit Namensnennung]

Prof. Reich

Prof. Dr. med. Kristian Reich
Dermatologie, Allergologie
Psoriasis- und Neurodermitis-Trainer
Hamburg

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The IXORA-S study compared the efficacy and safety of Taltz® (ixekizumab) and Stelara®* (ustekinumab) for the treatment of moderate-to-severe plaque psoriasis at 24 weeks.

In this study, patients were randomized to receive either Stelara (45 mg or 90 mg weight-based dosing per label) or Taltz (80 mg every two weeks followed by 80 mg every four weeks), following an initial starting dose of 160 mg. At 24 weeks, patients treated with Taltz achieved significantly higher response rates compared to patients treated with Stelara, including 83 percent of patients who achieved Psoriasis Area Severity Index (PASI) 90—the study’s primary endpoint—compared to 59 percent of patients who achieved PASI 90 after treatment with Stelara.

Results at 24 weeks also found:
• 91.2 percent of patients treated with Taltz achieved PASI 75 compared to 81.9 percent of patients treated with Stelara (p=0.015)
• 49.3 percent of patients treated with Taltz achieved PASI 100 compared to 23.5 percent of patients treated with Stelara (p=0.001)
• 86.6 percent of patients treated with Taltz achieve static Physician’s Global Assessment score (sPGA) 0 or 1 compared to 69.3 percent of patients treated with Stelara (p<0.001)

The majority of treatment-emergent adverse events were mild or moderate. There were no statistically significant differences between treatment groups in overall treatment-emergent adverse events. The safety profile for Taltz was consistent with previous clinical trials.

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Doxycycline vs Steroids For Blistering Disease Bullous Pemphigoid

MedicalResearch.com Interview with:

Hywel C. Williams DSc, FMedSci, NIHR Senior Investigator Director of the NIHR Health Technology Assessment Programme Professor of Dermato-Epidemiology and Co-Director of the Centre of Evidence-Based Dermatology, University of Nottingham Queen’s Medical Centre Nottingham University Hospitals NHS Trust, Nottingham, UK

Dr. Williams

Hywel C. Williams DSc, FMedSci, NIHR Senior Investigator
Director of the NIHR Health Technology Assessment Programme
Professor of Dermato-Epidemiology and
Co-Director of the Centre of Evidence-Based Dermatology,
University of Nottingham
Queen’s Medical Centre
Nottingham University Hospitals NHS Trust,
Nottingham, UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Pemphigoid is a potentially serious skin condition characterised by the appearance of large tense blisters appearing on the skin. These blisters are itchy and eventually burst, leaving raw areas of skin that can become infected. Pemphigoid is much commoner in the elderly, and is on the increase. It is due to the body’s own immune system attaching certain structures in the skin ie an auto-immune disease. The main treatment for pemphigoid is oral steroids (prednisolone). Prednisolone is usually quite good at clearing the blisters, but when given for long periods as is needed for people with pemphigoid, they cause serious side effects such as diabetes, infection, raised blood pressure and fractures, so safer oral treatments are needed for this disease. Tetracycline antibiotics are one such possible treatment – they have been used by some for pemphigoid for many years, but our Cochrane review did not find any good evidence to show that it works.

So we applied to the UK National Institute of Health Research Health Technology Programme to do a definitive evaluation of treating pemphigoid with one of the tetracyclines called doxycycline. We tested the strategy of staring patients with pemphigoid with doxycycline versus standard treatment with oral prednisolone. If those starting on doxycycline did not achieve good enough control, they could switch to prednisolone as would happen in clinical practice. Our main outcomes were blister control at 6 weeks, and severe, life threatening and fatal treatment related adverse events at 52 weeks. The study was designed as a non-inferiority study – by that we mean that we never expected doxycycline to be as good as prednisolone for blister control, so we agreed to put up with a degree of lower effectiveness provided that there were clear long term safety gains.

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Comparison of Posttransplant Dermatologic Diseases by Race

MedicalResearch.com Interview with:
Christina Lee Chung, MD, FAAD
Associate Professor of Dermatology
Director, Center for Transplant Patients
Drexel University College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It’s long been recognized immunosuppressed organ transplant recipients are at significantly increased risk for skin cancer and other types of skin disease.

But despite advances to improve skin cancer prevention for these patients, little is known about how skin conditions affect African-American, Asian and Hispanic transplant recipients. This is problematic given that, according to the U.S. Department of Health and Human Services, more than half of the 120,000 Americans on the waiting list for organs identify as nonwhite.

We compared medical records of 412 organ transplant recipients — including 154 white patients and 258 nonwhite (black, Asian or Hispanic) — who were referred to the Drexel Dermatology Center for Transplant Patients between 2011 and 2016. As one of the only models of its kind in the country, the center provides post-transplant dermatological care to every patient who is transplanted by and/or followed by the Drexel University and Hahnemann University Hospital Transplant Programs. That means that every patient, regardless of race, is screened annually for skin cancer, which provided a unique dataset for us to analyze.

Two hundred eighty-nine transplant recipients exhibited malignant, infectious or inflammatory conditions during their evaluation, but their primary acute diagnoses differed greatly by race. In 82 white patients, skin cancer was the most common acute problem requiring attention at first visit. Black and Hispanic patients, by contrast, were most often diagnosed with inflammatory or infectious processes, such as fungal infections, warts, eczema, psoriasis, and rashes that required immediate medical attention.

Overall, squamous cell carcinoma in situ was the most common type of skin cancer diagnosed in each racial or ethnic group. But the location of the cancerous lesions again depended on the race of the patient. Most lesions in white and Asian patients occurred in sun-exposed areas of the body, like the scalp, neck, chest and back. For black patients, the lesions were primarily found in the groin.  Moreover, six of the nine lesions found on black patients tested positive for high-risk HPV strains, suggesting an association between the virus and skin cancer for African Americans.

We also provided questionnaires to 66 organ transplant recipients to find out more about the patients’ awareness of skin cancer prevention. Seventy-seven percent of white patients were aware their skin cancer risk was increased, compared to 68 percent of nonwhites. Only 11 percent of nonwhite patients reported having regular dermatologic examinations, compared to 36 percent of whites. Finally, 45 percent of white patients but only 25 percent of nonwhite reported knowing the signs of skin cancer.

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Psoriasis: Efficacy and Safety of Guselkumab vs Humira for Moderate to Severe Disease

MedicalResearch.com Interview with:

Andrew Blauvelt, M.D., M.B.A. President and Investigator Oregon Medical Research Center

Dr. Blauvelt

Andrew Blauvelt, M.D., M.B.A.
President and Investigator
Oregon Medical Research Center

 MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Findings from the Phase 3 VOYAGE 1 study showed that patients with moderate to severe plaque psoriasis receiving guselkumab, an human anti-interleukin (IL)-23 monoclonal antibody, achieved significant improvement in skin clearance and in comparison with Humira® (adalimumab), a TNF blocker.  The Phase 3 study and head-to-head analysis of guselkumab vs. adalimumab showed the significant and durable efficacy of guselkumab as maintained through one year when compared with adalimumab, and the robust efficacy of this novel IL-23 targeted therapy in meeting all primary and major secondary endpoints.

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Indoor Tanning By High School Students Drops By Half

MedicalResearch.com Interview with:

Gery P. Guy Jr., PhD, MPH Senior Health Economist Division of Unintentional Injury CDC

Dr. Gery Guy

Gery P. Guy Jr., PhD, MPH
Senior Health Economist
Division of Unintentional Injury
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The incidence of skin cancer is increasing in the United States, and individuals who indoor tan are at an increased risk of skin cancer. Treating skin cancer costs $8.1 billion annually.

The number of high school students who indoor tan dropped by half from 2009 to 2015. In 2015, 1.2 million high school students indoor tanned, down from 2.5 million in 2009. This is a much bigger decrease than we have seen in the past and is an encouraging finding. We also found that 82% of indoor tanners reported sunburn in the past year compared with 54% of those who did not engage in indoor tanning.

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Skin Diseases A Major Cause of Disability Worldwide

MedicalResearch.com Interview with:

Chante Karimkhani, MD University Hospitals Case Western Medical Center, Cleveland, Ohio now with Department of Dermatology University of Colorado, Denver

Dr. Karimkhani

Chante Karimkhani, MD
University Hospitals Case Western Medical Center, Cleveland, Ohio
now with Department of Dermatology
University of Colorado, Denver

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Ranging from benign inflammatory to infectious, autoimmune, and malignant conditions, skin diseases cause significant disfigurement, pain, and psychological morbidity. The Global Burden of Disease (GBD) Study 2013 is a large-scale epidemiological assessment of burden from 306 diseases in 195 countries, both sexes, and 14 age groups. Disease burden is measured by combining morbidity and mortality into a single metric of disability-adjusted life years (DALYs), where one DALY is equivalent to one year of healthy life lost. Skin diseases contributed 1.79% of the total global burden from all diseases.

The skin diseases arranged in order of decreasing global DALYs are: dermatitis (atopic, contact, seborrheic), acne vulgaris, urticaria, psoriasis, viral skin diseases, fungal skin diseases, fungal skin diseases, scabies, melanoma, pyoderma, cellulitis, keratinocyte carcinoma (basal and squamous cell carcinomas), decubitus ulcer, and alopecia areata. Younger populations had the greatest burden from infectious skin conditions, while acne caused the greatest burden in the second and third decades of life. Elderly populations had the greatest DALY rates from melanoma and keratinocyte carcinoma. Skin conditions also exhibit distinct geographical patterns of disease burden.

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Musculoskeletal Symptoms May Mark Onset of Arthritis in Psoriasis Patients

MedicalResearch.com Interview with:

Lihi Eder MD PhD Rheumatologist, Women’s College Hospital Scientist, Women’s College Research Institute Assistant Professor of Medicine, University of Toronto Toronto, ON, Canada

Dr. Lihi Eder

Lihi Eder MD PhD
Rheumatologist, Women’s College Hospital
Scientist, Women’s College Research Institute
Assistant Professor of Medicine, University of Toronto
Toronto, ON, Canada

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There significant delays in the diagnosis of psoriatic arthritis (PsA) among patients with psoriasis. Many patients with psoriasis experience musculoskeletal symptoms. The majority of them do not have PsA, but other non-inflammatory conditions such as fibromyalgia or osteoarthritis.

In this study, we aimed to assess whether the presence and the degree of musculoskeletal symptoms in psoriasis patients predict the development of psoriatic arthritis. We analyzed a cohort of 410 psoriasis patients who were followed over a period of 9 years. These patients did not have arthritis at baseline. The patients were assessed annually by a rheumatologist for signs of PsA. A total of 57 patients developed psoriatic arthritis during the follow-up period.
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Guselkumab Potentially Increases Treatment Choices For Psoriasis

MedicalResearch.com Interview with:

Prof. Dr. med. Kristian Reich Dermatologie, Allergologie Psoriasis- und Neurodermitis-Trainer Hamburg

Prof.  Kristian Reich

Prof. Dr. med. Kristian Reich
Dermatologie, Allergologie
Psoriasis- und Neurodermitis-Trainer
Hamburg

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Ustekinumab is an antibody against the p40 molecule shared by IL-12 and IL-23. The antibody shows a favorable benfit-risk profile in the treatment of psoriasis. IL-23 is regarded a key driver in psoriasis pathology. It is speculated that antibodies against the IL-23-specific subunit p19 may produce even higher levels of clinical response than ustekinumab or the anti-TNF antagonist adalimumab. Guselkumab is the first IL-23p19 antibody to publish phase III data in psoriasis.   
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Leaky Gate Model Connects Intense Itch With Pain

MedicalResearch.com Interview with:

Xinzhong Dong PhD The Solomon H. Snyder Department of Neuroscience and Center for Sensory Biology Howard Hughes Medical Institute Johns Hopkins University School of Medicine Baltimore, MD 21205

Dr. Xinzhong Dong

Xinzhong Dong PhD
The Solomon H. Snyder Department of Neuroscience and Center for Sensory Biology
Howard Hughes Medical Institute
Johns Hopkins University School of Medicine
Baltimore, MD 21205

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is a puzzle that troubles the field for many years that how pain and itch, two closely related sensations (once thought as one sensation), are differentiated by the nervous systems. Coding of pain and itch are heatedly debated for decades. The current specificity theory suggests that these two kinds of signals are carried by separate pathways, with some interactions, for example pain can inhibit itch and that explains why we all scratch to inhibit pain. It is true in the periphery (our previous study indicate a small population of neurons in the periphery only codes for itch sensation), but now our study suggests that there could be more crosstalk between these two sensations in the central than we expected.

People might not notice in real life, but in human psychophysical studies, well-isolated experimental environments, when human subjects are given itchy substances, they typically report intense itch sensations accompanied by minor noxious sensations, such as pricking, stinging and burning. Our new leaky gate model suggest in certain circumstances intense itch signals can trigger minor pain sensations, which can explain such phenomenon.

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Sun Protective Behaviors In Patients With Cutaneous Hyperpigmentation

MedicalResearch.com Interview with:

Neelam A. Vashi, MD Assistant Professor of Dermatology Boston University Center of Ethnic Skin

Dr. Vashi

Neelam A. Vashi, MD
Assistant Professor of Dermatology
Boston University Center of Ethnic Skin  and

Mayra B. C Maymone, MD, DSc Doctor of Science, Dermatology Boston University School of Medicine Boston, MA

Dr.-Maymone

Mayra B. C Maymone, MD, DSc
Doctor of Science, Dermatology
Boston University School of Medicine
Boston, MA

MedicalResearch.com: What is the background for this study?
What are the main findings?

Response: Disorders of hyperpigmentation are common in clinical practice and frequently observed in dark-skinned individuals, a subset of the population that reportedly engages less with sunscreen use and other sun-protective behaviors. With the expected shift in US demographics to become a more racially and ethnically diverse population, there is growing interest in finding out more about the sun-protective habits in those with cutaneous hyperpigmentation.

In this cross-sectional study, we found a surprisingly high rate of sunscreen use (67.5%). This is much higher than that observed in the general population and similar to rates observed in individuals with photosensitive disorders and skin cancer. However, the frequency of sunscreen reapplication and other sun-protective measures such as seeking shade and wearing hats were less commonly adopted in our study participants, emphasizing that even in a highly motivated population there is still room for improvement.

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Cooling System Can Prevent Hair Loss During Chemotherapy

MedicalResearch.com Interview with:

Julie Rani Nangia, M.D. Assistant Professor Breast Center - Clinic Baylor College of Medicine Houston, TX, US

Dr. Julie Nangia

Julie Rani Nangia, M.D.
Assistant Professor
Breast Center – Clinic
Baylor College of Medicine
Houston, TX, US

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study was fueled by the feedback from women undergoing chemotherapy treatment for breast cancer. One of the most distressing side effects of their treatment is hair loss. It robs them of their anonymity and, for many, their femininity. Scalp cooling therapy has been available for a few years in the UK, but has faced obstacles in FDA clearance in the states. The makers of the scalp cooling device used in this study, Paxman Coolers Ltd., have a personal connection to breast cancer, as the company founder’s wife passed away from the disease.

This was the first randomized scalp cooling study, and it shows that the Paxman Hair Loss Prevention System is an effective therapy for reducing chemotherapy-induced alopecia. The results show a 50% increase in hair preservation of grade 0 or 1, meaning use of a scarf or wig is not necessary, in patients who received the scalp cooling therapy as opposed to those who did not.

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Diabetes Drug May Enhance Melanoma Chemotherapy

MedicalResearch.com Interview with:

Bin Zheng, PhD Assistant Professor Cutaneous Biology Research Center Massachusetts General Hospital Harvard Medical School Charlestown, MA 02129

Dr. Bin Zheng

Bin Zheng, PhD
Assistant Professor
Cutaneous Biology Research Center
Massachusetts General Hospital
Harvard Medical School
Charlestown, MA 02129 

MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Melanoma is the most deadly form of skin cancer with more than 75,000 newly diagnosed cases in the US each year. Over the years, various genetic driver mutations have been identified that cause melanoma, including mutations in the genes BRAF and NRAS. Recent genetic insights into the development of melanoma showed that also mutations in NF1 can lead to melanoma. While there are targeted therapies available for BRAF-mutant melanoma, thus far no such therapies are available for NF1-mutant melanoma. We identified that using a combination of an ERK inhibitor, SCH772984, and the antidiabetic drug phenformin could provide a novel therapeutic strategy for NF1-mutatnt melanomas.

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Moisturizers Reduce Severity of Eczema

MedicalResearch.com Interview with:

Dr. Esther van Zuuren

Dr. Esther van Zuuren

Esther van Zuuren MD
on behalf of the authors
Department of Dermatology
Leiden University Medical Center
Leiden, Netherlands

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In view of the high prevalence of eczema and the exponential increase in number of clinical trials over recent years, the NIHR designated this clinical topic, emollients and moisturisers for eczema, as a high priority. Widely prescribed as the basis of eczema management the treatment strategy is often supported by a mixed array of reviews and guidelines. Evidence for the effectiveness of emollients and moisturisers is also of variable quality.

Eczema is a chronic skin disorder, the main symptoms being dry skin and intense itching with a significant impact on quality of life. As dry skin is an important feature, moisturisers are a cornerstone of eczema treatment, but there was uncertainty about their efficacy and whether one moisturiser is preferable to another. The main finding of our review is that indeed moisturisers are effective.

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Sunscreen Use Beats Shade For Preventing Sunburn

MedicalResearch.com Interview with:

Hao Ou-Yang, PhD Johnson & Johnson Consumer Inc Skillman, New Jersey

Dr. Hao Ou-Yang

Hao Ou-Yang, PhD
Johnson & Johnson Consumer Inc
Skillman, New Jersey

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This is the first-ever published study to evaluate UV protection value of shade in a real-world setting.

Eighty-one subjects with Fitzpatrick skin type I to III were divided into two groups: one using only a commercially available beach umbrella (round-shaped, 80” diameter, 75” high) and the other using only Neutrogena® Ultra Sheer® SPF 100+ sunscreen. Sunscreen subjects were monitored applying the product to all exposed areas following the label directions 15 minutes before beach exposure and were instructed to re-apply at least every 2 hours or as needed. Subjects were instructed to stay at the beach for 3.5 hours but could leave or stay under a shade for up to 30 minutes for cooling or rest. Shade subjects were instructed to stay under the umbrella without wearing clothes that could block the evaluated areas during the study duration. They were allowed to leave the umbrella after covering up for up to 30 minutes.

There were significant differences between the two groups in clinically evaluated sunburn protection for all seven body sites measured. The Ultra Sheer SPF 100+ sunscreen provided excellent sunburn protection for all the body sites, as demonstrated by no significant changes in sunburn grading before and after UV exposure in any sites except for face. Of the subjects in the shade group, there were a total of 142 sunburn areas across all parts of the body in 78% of the umbrella group (vs. 17 areas among 10 people in the sunscreen group – 25%). Sunburn incidence within the sunscreen group may be due to uneven application (missed spots), failure to re-apply after sweating, and under-application. Most subjects in the sunscreen group applied roughl yhalf of the amount of sunscreen recommended to achieve the SPF value on the label.

High SPF products provide a margin of safety for consumers who under-apply, as shown here and in other studies.

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How Do Tattoo Artists Handle Moles?

MedicalResearch.com Interview with:

Westley Mori, fourth-year medical student (MSIV) University of Pittsburgh Medical School

Westley Mori

Westley Mori, fourth-year medical student (MSIV)
University of Pittsburgh Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Tattooed skin represents an important diagnostic challenge for the dermatologist performing a skin cancer screening. Several case reports have described melanoma being hidden in tattoos.

To our knowledge, our study is the first of its kind investigating the approach of the tattoo artist to skin with melanocytic nevi (moles) or other skin lesions. We found that the approach to tattooing skin spots is highly variable, with some artists tattooing around moles and others simply tattooing over them.

The final cosmetic outcome—not the potential for skin cancer—is often the paramount concern for artists. Those artists with a personal or family history of skin cancer were more likely to refuse inking over a skin spot and recommend the client see a dermatologist.

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Hidradenitis Suppurativa and Inflammatory Bowel Disease Strongly Linked

MedicalResearch.com Interview with:

Alexander Egeberg, MD PhD National Allergy Research Centre, Departments of Dermato-Allergology and Cardiology Herlev and Gentofte University Hospital, University of Copenhagen Hellerup, Denmark

Dr. Alexander Egeberg

Alexander Egeberg, MD PhD
Gentofte Hospital
Department of Dermatology and Allergy
Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Inflammatory bowel disease (IBD) has been associated with increased prevalence of HS, but data has been limited to small studies and even less is known about the concurrence and risk of new-onset IBD in patients with pre-existing HS.

In our study, we found a higher prevalence of Crohn’s disease and ulcerative colitis in patients with HS. Notably, there was a more than two-fold increased risk of new-onset Crohn’s disease and a 63% increased risk of new-onset ulcerative colitis in patients with Hidradenitis suppurativa compared with the general population.

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In Global Survey, Risks of Sun Exposure and Tanning Not Well Known

MedicalResearch.com Interview with:

Dr. Sophie Seite

Dr. Sophie Seite

Sophie Seite, Ph. D
La Roche-Posay Dermatological Laboratories
Asnières, France.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The survey included nearly 20,000 men and women in 23 countries, ages 16-65, and was primarily conducted online. The questionnaire collected data regarding demographics, sun exposure, behaviors regarding prevention and tanning, risk knowledge, self-examination, medical advice seeking, and social attitude. This unprecedented international survey on sun exposure behaviors and skin cancer detection found that there are many imperfections and geographical inequalities in primary and secondary prevention of skin cancer.

The study was published in the Journal of the European Academy of Dermatology & Venereology by researchers from La Roche-Posay and the George Washington University (GW) Department of Dermatology. Survey results indicate that 88 percent of those questioned were aware of the risks of developing skin cancer when exposed without protection to the sun. However, just 1 in 2 respondents has ever consulted a dermatologist for a mole screening and 4 in 10 people don’t think to protect themselves from the sun outside of vacation.

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Drug Use Common in Patients with Delusional Infestation

MedicalResearch.com Interview with:

Dr Anthony Bewley FRCP Consultant Dermatologist Whipps Cross University Hospital & The Royal London Hospital

Dr Anthony Bewley

Dr Anthony Bewley FRCP
Consultant Dermatologist
Whipps Cross University Hospital
& The Royal London Hospital 

MedicalResearch.com: What is the background for this study?

Response: Delusional infestation (DI) is a very disabling condition, whereby patients hold a fixed, unshakeable false belief of being infested with insects or other inanimate objects such as fibres and threads.

Previous studies have indicated a high rate of recreational drug use amongst patients with delusional infestation (DI).

The aim of our pilot study was to look at the prevalence of recreational drug use in patients with delusional infestation who attended clinic over a three year period (Group 1). We also prospectively offered a urine drugs test to 24 consecutive patients over a three month period (Group 2).

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Guselkumab Bests Adalimumab in Psoriasis Study

MedicalResearch.com Interview with:

Andrew Blauvelt, M.D., M.B.A. President and Investigator Oregon Medical Research Center Portland, OR 97223

Dr. Andrew Blauvelt

Andrew Blauvelt, M.D., M.B.A.
President and Investigator
Oregon Medical Research Center
Portland, OR 97223

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Findings from the guselkumab Phase 3 VOYAGE 1 study showed that patients with moderate to severe plaque psoriasis receiving the anti-interleukin (IL)-23 monoclonal antibody (mAb) achieved significant improvements in skin clearance compared with patients receiving placebo and patients receiving Humira® (adalimumab), a TNF blocker. The Phase 3 study and head-to-head analysis of guselkumab vs. adalimumab in the treatment of moderate to severe plaque psoriasis also showed the significant efficacy of guselkumab maintained through week 48 compared with adalimumab, and the robust efficacy of guselkumab in meeting all primary and major secondary endpoints.

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Regional and State Differences in Melanoma Rates in the US

MedicalResearch.com Interview with:
Jessica S. Mounessa, BS
Robert P. Dellavalle, MD, PhD, MSPH
Dermatology Service, Denver Veterans Affairs Medical Center, Denver, Colorado
Department of Dermatology, University of Colorado School of Medicine, Aurora

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Skin cancer remains the most common cancer in the U.S., despite ongoing efforts to address this major public health problem. Over 9,000 deaths occur annually, and mortality rates continue to increase faster than those associated with any other preventable cancer. Malignant melanoma, the deadliest type of skin cancer, accounts for the overwhelming majority of these deaths.

Our study identified regional and state differences in the incidence and mortality rates of melanoma in the United States. We found that the Northeast, specifically New England, represents the only U.S. region in which the majority of states experienced a reduction in both incidence and death rates over the ten-year period between 2003 and 2013.

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Psoriasis Associated With Increased Risk of Avascular Bone Death

MedicalResearch.com Interview with:

Psoriasis

Psoriasis

Hsien-Yi Chiu, MD/
Tsen-Fang Tsai, MD

Department of Dermatology, National Taiwan University Hospital
Taipei, Taiwan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Psoriasis is a chronic, immune-mediated disorder, characterized by red, itchy and scaly skin patches. Over the past several years, accumulating research had shown the effects of psoriasis go far deeper than the skin and psoriasis is associated with multiple comorbidities.

Psoriasis shares the inflammatory pathways and several contributing factors with avascular necrosis (AVN), a bone disease presented with death of trabecular bone and collapse of the bony structure. However, previous studies mostly focus on evaluation the increased risk of cardiovascular diseases in patients with psoriasis. No large scale studies have previously explored a potential association between psoriasis and AVN.

Our nationwide population-based cohort study investigated this risk in 28268 patients with psoriasis registered in the Taiwan National Health Insurance Research Database. The patients were matched, by age and sex, with 113072 controls without psoriasis. Both the patients and controls were followed to identify those who subsequently diagnosed with an AVN. The results showed that psoriasis was associated with a disease severity–dependent increase in avascular necrosis risk. Moreover, AVN risk was positively associated with male sex, age younger than 30 years, corticosteroid use, severe psoriasis, and concomitant psoriatic arthritis. People with severe psoriasis were 3 times more likely to develop AVN compared with the control group.

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Two Polyomaviruses Linked To Dermatoses in Immunocompromised Patients

MedicalResearch.com Interview with:

Richard Wang, M.D., Ph.D. Assistant Professor UT Southwestern Medical Center

Dr. Wang

Richard Wang, M.D., Ph.D.
Assistant Professor
UT Southwestern Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:

Currently, there are 13 polyomaviruses known to infect humans. Several members of this family of double-stranded DNA viruses—including Merkel Cell Polyomavirus, Trichodysplasia Spinulosa Polyomavirus, Human Polyomavirus 6 (HPyV6), and Human Polyomavirus 7 (HPyV7)—can be shed from skin of healthy individuals. While most polyomavirus infections are common and subclinical, several polyomaviruses have been associated with debilitating diseases in immunocompromised individuals. Most recently, HPyV7 was discovered in a pruritic and dyskeratotic eruption in two immunosuppressed transplant patients. A closely related polyomavirus, Human Polyomavirus 6, has not yet been strongly linked to any infectious diseases. Using the previously described, characteristic histologic pattern, we identify 3 additional cases of skin eruptions associated with infections of HPyV6 and HPyV7. The association of the dermatoses with highly active infections were confirmed through electron microscopy, immunohistochemistry, quantitative PCR, and complete sequencing. HPyV7 infects keratinocytes and affects their normal differentiation. In addition, next generation sequencing revealed that HPyV6 could persist in a latent state in the skin of a previously infected patient.

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Is Skin Cancer Screening Cost Effective?

MedicalResearch.com Interview with:
Isabelle Hoorens, MD, PhD

Department of Dermatology
Ghent University Hospital
Ghent, Belgium

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In this study we questioned whether a population-based screening for skin cancer is cost-effective.

In addition we compared the cost-effectiveness of two specific screening techniques. The first technique, a lesion-directed screening being a free-of-charge skin cancer check of a specific lesion meeting 1 or more of the following criteria: ABCD rule (asymmetry, border irregularity, color variation, and diameter >6 mm), “ugly duckling” sign, new lesion lasting longer than 4 weeks, or red nonhealing lesions.

The second screening technique consisted of a systematic total body examination in asymptomatic patients. A clinical screening study was performed in Belgium in 2014. Continue reading

Are Co-Morbidities in Psoriasis Overestimated?

MedicalResearch.com Interview with:

Psoriasis

Psoriasis

Mohammed D. Saleem, MD
Department of Dermatology
Wake Forest School of Medicine
Medical Center Boulevard
Winston-Salem, NC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Over the past several years’ numerous research studies have identified comorbidities associated with psoriasis. The media has increasingly become involved with presenting these findings and patients commonly bring these concerns to their physician. The comorbidities are often presented as a relative risk, which can overestimate the effects of exposure, especially when the incidence is quite small. Comorbidities presented as attributed risk or number needed to harm might be a better measure for understanding the association between an exposure and comorbidity.

We found that although the relative risk of many diseases associated with psoriasis can be quite large, the attributed risk was small.

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Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma

MedicalResearch.com Interview with:
Hywel C. Williams DSc, FMedSci, NIHR Senior Investigator

Director of the NIHR Health Technology Assessment Programme
http://www.nets.nihr.ac.uk/programmes/hta
Professor of Dermato-Epidemiology and Co-Director of the Centre of Evidence-Based Dermatology,
http://www.nottingham.ac.uk/research/groups/cebd/index.aspx
University of Nottingham,
Queen’s Medical Centre,
Nottingham University Hospitals NHS Trust,
Nottingham UK

Hywel C. Williams

Basal Cell Skin Cancer-Wikipedia image

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our clinical trial of 5% imiquimod cream versus surgery for low risk basal carcinoma (BCC) of the skin was first prompted by a shocking lack of randomised controlled clinical trials for what is the commonest form of human cancer.

We had conducted a Cochrane systematic review prior to starting the study and found very few long term studies. An emerging literature on imiquimod cream at the time suggested that it might have a clinically useful effect for low risk BCC. All the studies were short term and industry supported, so with the support of Cancer Research UK (UK largest cancer charity), we undertook a large independent study to see how the cream compared to the reference standard of excision surgery with a 4mm margin for low risk superficial and nodular BCC.

Our three year results, published in Lancet Oncology, showed that surgery is clearly superior to imiquimod cream, with a success rate (absence of initial failure and no signs of recurrence at 3 years) of 98.4% compared to 83.6% for imiquimod. Nevertheless, the 83.6% success rate is still potentially useful, so we wanted to see whether these 3 year results were sustained. So we followed up your study participants for a total of 5 years and found that the response rates at 5 years were almost the same as those at 3 years (97.7% and 82.5% for surgery and imiquimod respectively).

Most treatment failures with imiquimod occurred early on ie in the first year of treatment. Our study shows that if initial treatment works, the benefits are sustained.

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Patients and Partners Not Embarrassed To Do Skin Cancer Examinations On Each Other

MedicalResearch.com Interview with:

June K. Robinson, MD Research Professor of Dermatology Northwestern University Feinberg School of Medicine Department of Dermatology Chicago, IL 60611

Dr. June Robinson

June K. Robinson, MD
Research Professor of Dermatology
Northwestern University Feinberg School of Medicine
Department of Dermatology
Chicago, IL 60611

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This is a secondary finding from a randomized controlled trial of a structured skills training program for melanoma patients and their skin check partners.

The pairs learned and performed skin self-examination for the early detection of melanoma. They continued to perform skin checks for 2 years and trained pairs identified more early melanoma (melanoma in situ and Stage 1A melanoma) than controls.

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Pubic Hair Grooming Linked To Increased Risk of STDs

MedicalResearch.com Interview with:

E. Charles Osterberg, M.D. Assistant Professor of Surgery Genitourinary Reconstruction and Trauma University of Texas- Dell Medical School Dell-Seton Medical Center / University Hospital

Dr. Osterberg

E. Charles Osterberg, M.D.
Assistant Professor of Surgery
Genitourinary Reconstruction and Trauma
University of Texas- Dell Medical School
Dell-Seton Medical Center / University Hospital

MedicalResearch.com: What is the background for this study?

Response: Pubic hair grooming has become an increasingly common practice among men and women. Perceptions of genital normalcy have changed as modern society’s definition of attractiveness and feelings of femininity and masculinity have changed. Pubic hair grooming has been shown to increase morbidity such as genital injuries, however little is known about the relationship between grooming practices and sexually transmitted infections.

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Patients Prefer Online Portal To Receive Skin Biopsy Results

MedicalResearch.com Interview with:

sophia-akhiyatSophia Akhiyat
M.D. Candidate, Class of 2017
The George Washington University School of Medicine and Health Sciences
METEOR Fellowship

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our study was inspired by one of Choudhry et al,1 in which patients’ preferences for skin biopsy result disclosure was surveyed at melanoma clinics affiliated with several academic institutions. We sought to broaden participant inclusion criteria by evaluating patients’ preferences at a general dermatology clinic at an academic center.

Our findings support that the highest ranked patient-preferred method for receiving skin biopsy results was through an online portal. Patients also reported that the most important factors when selecting a modality for communication were the amount of information given and time available to discuss results. We also observed a relationship between a younger patient age range and online portal experience as well as a preference for biopsy notification via online portal.

1Choudhry A, Hong J, Chong K, et al. Patients’ Preferences for Biopsy Result Notification in an Era of Electronic Messaging Methods. JAMA Dermatol. 2015;151(5):513-521.

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Moisturizers Are Cost-Effective Mainstay of Eczema Treatment

MedicalResearch.com Interview with:

Steve Xu MD, MSc Resident Physician Department of Dermatology Northwestern Feinberg School of Medicine

Dr. Steve Xu

Steve Xu MD, MSc
Resident Physician
Department of Dermatology
Northwestern Feinberg School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Given the limited data on the effectiveness or safety of the different moisturizers examined in the study, how much do you think parents should decide what to use on their babies based on the “cost-effectiveness” determined in this study? Would you just say cheapest is best since we don’t know how well these things work? Or what’s the message?

Price. Petrolatum is an extremely effective moisturizer. It also happens to be one of the most affordable. Unlike adults, I don’t suspect newborns will complain too much about the greasiness of petrolatum. They’re less concerned that their work clothes will get ruined. They are less likely to care about cosmetic elegance.

I also will say that petrolatum is less likely to include any artificial fragrances, preservatives that could serve as irritants or allergens in the future. That’s an added bonus.

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Thin Melanomas Have Surprisingly High Mortality Risk

MedicalResearch.com Interview with:

Shoshana M. Landow, MD, MPH FAAD Dermatoepidemiology Unit Providence Veterans Affairs Medical Center Providence, RI 02908.

Dr. Shoshana M. Landow

Shoshana M. Landow, MD, MPH FAAD
Dermatoepidemiology Unit
Providence Veterans Affairs Medical Center
Providence, RI 02908.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Interest for this study arose from a realization that a large number of deaths from thin melanomas have been documented in SEER. Since prognosis worsens with depth for thicker melanomas, we sought to evaluate whether it was the “thicker” of the thin melanomas that accounted for most of the deaths. We were surprised to find that when we restricted our study to melanomas diagnosed at Stage I and II, the greatest number of deaths at 10 years caused by these melanomas resulted from those 1.00mm and less in depth. We were also surprised to find that prognosis for ultra-thin melanomas, 0.01-0.25mm in depth, was not better than those 0.26-0.50mm, as we had expected.

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Teledermatology Can Triage Many Post-Operative Skin Surgery Concerns

MedicalResearch.com Interview with:

Rajiv Nijhawan MD Department of Dermatology The University of Texas Southwestern Medical Center Dallas

Dr. Rajiv Nijhawan

Rajiv Nijhawan MD
Department of Dermatology
The University of Texas Southwestern Medical Center
Dallas

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: From a healthcare perspective, we are constantly working to improve access to patients, and telemedicine has proved to be an excellent platform for this goal especially in the field of dermatology. In regards to surgical dermatology, the role of telemedicine has been limited. The ubiquity of smartphones with photograph capability has provided an opportunity for patients to take self-acquired photographs (selfies) easily. Our experience has been that few patients who call with post-operative concerns have major issues (e.g. infection, bleeding, etc.) while the majority of concerns are minor in nature, and patients are often seeking reassurance.

Our study shows that the majority of concerns can easily be triaged and managed through patient-directed photography without burdening the patient to take time off work for another appointment, find transportation/travel (many of our patients travel hours for their visits), wait to see the provider, etc. This option of triaging a post-operative concern essentially immediately through the use of patient-directed photographs provides the opportunity for immediate feedback on the patient’s concerns and likely reduces anxiety while making the process as patient-centered as possible. In addition, it allows the physician to be as efficient as possible by not having to overbook his/her schedule to accommodate these often non-urgent concerns.

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No Increased Risk of IBD Among Secukinumab-Treated Patients with Moderate to Severe Psoriasis in Phase 2 & 3 Clinical Studies

MedicalResearch.com Interview with:

Atul Deodhar, M.D., M.R.C.P. Rheumatology Oregon Health and Science University

Dr. Atul Deodhar

Atul Deodhar, M.D., M.R.C.P.
Rheumatology
Oregon Health and Science University 

MedicalResearch.com: What is the background for this study?

Response: Patients with psoriasis, psoriatic arthritis (PsA), or ankylosing spondylitis (AS) are at an increased risk of developing inflammatory bowel disease (IBD) compared with the general population. It is important that we assess whether new therapies, including the recently approved interleukin-17A (IL-17A) inhibitor, secukinumab, have an acceptable profile in terms of the risk of IBD in patients with psoriasis, PsA, or AS.

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Three Genes Responsible For Uncombable Hair Syndrome

MedicalResearch.com Interview with:
Prof. Dr. Regina Betz and
Dr. Buket Basmanav Ünalan
(first author)
Institute of Human Genetics
University of Bonn
Bonn, Germany

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Up to know, the cause for uncombable hair was totally unknown. We identified now mutations in three genes, all being responsible for uncombable hair syndrome. Of interest, the corresponding proteins, namely, PADI3, TGM3 and TCHH, are all in the same cascade that is responsible for the formation and mechanical strengthening of the hair shaft.

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Squamous Cell Carcinoma of Lip Predominantly Affects White Men in Their Mid-60s

MedicalResearch.com Interview with:

Albert Yoon-Kyu Han, PhD Class of 2017 Medical Scientist Training Program David Geffen School of Medicine at UCLA

Dr. Albert Han

Albert Yoon-Kyu Han, PhD
Class of 2017
Medical Scientist Training Program
David Geffen School of Medicine at UCLA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Squamous cell carcinoma (SCC) of the lip makes up a large portion of oral cancers (25%). Most of the demographic and prognostic indicators for lip SCC are only available through retrospective case series. Thus, we used the national cancer database (Surveillance, Epidemiology, and End Results, or SEER) to examine the incidence, treatment, and survival of patients with lip SCC.

The main findings of this study were that lip Squamous cell carcinoma predominantly affects white men in their mid-60s. We also found that the determinants of survival for lip SCC include age at diagnosis, primary site, T stage, and N stage. More specifically, on the primary site, SCC of the upper and lower lip had similar survival, whereas SCC of the oral commissure was associated with decreased survival.

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Cutaneous Fungal Infections Are Commonly Misdiagnosed

MedicalResearch.com Interview with:

Adam Friedman, MD, FAAD Associate Professor of Dermatology Residency Program Director Director of Translational Research Department of Dermatology George Washington School of Medicine and Health Sciences

Dr. Adam Friedman

Adam Friedman, MD, FAAD
Associate Professor of Dermatology
Residency Program Director
Director of Translational Research
Department of Dermatology
George Washington School of Medicine and Health Sciences

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study was developed out of a session I and my colleague, Neal Bhatia, held at the 2016 Orlando Dermatology Aesthetic and Clinical Conference.

As an interactive session which had the audience answer whether they clinically thought an image was representative of a fungal skin infection or not, we collected audience responses and were impressed by how even dermatologists struggle with making this diagnosis clinically. This is not so surprising given the protean nature and diverse presentations of these infections, not to mention the many mimics which are not due to infection. Only one of the thirteen images shown was appropriately diagnosed by 90% of the audience. This highlights that the importance of using bedside diagnostic techniques such as KOH preps and culture to identify underlying cause in order to appropriately use the right therapy for the right condition.

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Risk Factors For Adult Acne Identified

MedicalResearch.com Interview with:
Luigi Naldi, MD
Director Centro Studi GISED
Department of Dermatology
Azienda Ospedaliera papa Giovanni XXIII
Bergamo Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The study was the natural continuation of a previous case-control study focusing on risk factors for moderate to severe acne in adolescents. In that study, we documented the role of a westernized diet to influence acne severity, with a low weekly intake of fruits or vegetables, a low consumption of fresh fish and a high consumption of milk especially skim milk, being risk factors for moderate to severe acne. Not surprisingly, also a family history of acne was associated with acne severity.

After completion of our study in adolescents, we realized that very little was known about acne in adults. Hence, we started a new case-control study focusing on risk factors for adult female acne. Besides the role of a family history, we documented that lifestyle factors could play an important role in adult acne. More specifically, being an office worker, and having a high level of reported psychological stress were associated with acne in adult women. In addition, similarly to acne in adolescents, low weekly intake of fruits or vegetables and a low consumption of fresh fish were documented as risk factors.

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Immunotherapy Tofacitinib Can Halt Alopecia Areata

MedicalResearch.com Interview with:
Dr. Morton Scheinberg, MD, PhD
From Hospital Israelita Albert Einstein and Hospital AACD,
São Paulo, and
Clinica Dermatosineida, Maringa, Parana, Brazil.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: That universal hair loss associated with a localized autoimmune reaction on the cells involved with the hair follicles can be halted with tofacitinib.

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Mitotic Rate Correlates With Sentinel Lymph Node Status and Outcome in Cutaneous Melanoma

MedicalResearch.com Interview with:
Dr. Mario Mandalà, MD

Division of Oncology, Department of Oncology and Hematology
Papa Giovanni XXIII Hospital
Bergamo, Italy. 

MedicalResearch.com: What is the background for this study?

Response: The 7th edition of the TNM AJCC classification incorporated mitotic rate (MR) only for primary cutaneous melanoma with Breslow thickness ≤1 mm. We investigated whether and to what extent MR is able to predict sentinel lymph node (SLN) status and clinical outcome of  primary cutaneous melanoma (PCM) patients with BT >1 mm.

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Do Dysplastic Moles Need To Be Re-Excised?

MedicalResearch.com Interview with:
Timothy Patton, DO

Department of Dermatology
Falk Medical Center
University of Pittsburgh Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: As dermatologists we are confronted daily with how to manage lesions that are biopsied and diagnosed as dysplastic nevi. These lesions are considered by some to be potential melanoma precursors and by others as benign lesions with little to no malignant potential. Often, particularly for lesions with severe atypia these lesions are re excised. There are no prospective studies or consistent guidelines as to how to manage these lesions. We decided to retrospectively look at the outcome of 451 patients with dysplastic nevi with severe atypia, many of whom had not had their lesions re-excised, who had at least 5 years of follow up to determine if any developed melanoma at the site of the biopsied dysplastic nevus or distantly. We found no cases of metastatic melanoma in patients who did not already have a diagnosis of melanoma. We found two cases of thin melanoma in patients who had their lesions re-excised. Both of those patients were treated with reexcision and did not develop subsequent melanoma metastasis or recurrence. Continue reading

Skin Surveillance Can Be Tailored To Individuals at Higher Risk of Melanoma

MedicalResearch.com Interview with:

Caroline Watts| Research Fellow

Dr. Caroline Watts

Caroline Watts | Research Fellow
Cancer Epidemiology and Prevention Research
Sydney School of Public Health
Melanoma Institute Australia (MIA) investigator
The University of Sydney

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Melanoma Patterns of Care study was a population-based observational study of physicians’ reported clinical management of 2727 patients diagnosed with an in situ or invasive primary melanoma over a 12-month period from October 2006 to 2007 in New South Wales, Australia. This paper investigated the differences between 1052 (39%) patients who were defined as higher risk owing to a family history of melanoma, multiple primary melanomas, or many nevi (moles) compared to patients who did not have any risk factors.

We found that the higher-risk group had a younger mean age at diagnosis compared to those without risk factors, (62 vs 65 years, P < .001) which varied by type of risk factor (56 years for patients with a family history, 59 years for those with many nevi, and 69 years for those with a previous melanoma). These age differences were consistent across all body sites. Among higher-risk patients, those with many nevi were more likely to have melanoma on the trunk (41% vs 29%, P < .001), those with a family history of melanoma were more likely to have melanomas on the limbs (57%vs 42%, P < .001), and those with a personal history were more likely to have melanoma on the head and neck (21% vs 15%, P < .001).

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Rosacea May Be a Cutaneous Manifestation of Migraine

MedicalResearch.com Interview with:

Alexander Egeberg, MD PhD National Allergy Research Centre, Departments of Dermato-Allergology and Cardiology Herlev and Gentofte University Hospital, University of Copenhagen Hellerup, Denmark

Dr. Alexander Egeberg

Alexander Egeberg, MD PhD
Gentofte Hospital
Department of Dermatology and Allergy
Hellerup Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Patients with rosacea frequently report symptoms of migraine, and this link has been discussed for many years. However, very little research has actually been performed in this area, and the prevalence varies greatly between studies. We examined the prevalence of migraine in patients with rosacea, nationwide, as well as the risk of new-onset migraine in patients with manifest rosacea. We found a markedly increased prevalence of migraine among patients with rosacea. The risk of new-onset migraine was also higher among patients with rosacea, but only among women. Perhaps most notably was the observation that risk of new-onset migraine was highest among patients older than 50 years. This was surprising, since new-onset migraine in older individuals is often considered a “red flag”.

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JAK Inhibitor Tofacitinib Regrows Hair In Patients With Severe Alopecia Areata

MedicalResearch.com Interview with:

Brett A. King, MD, PhD Assistant Professoro Department of Dermatology School of Medicine Yale University New Haven, CT 06520

Dr. Brett King

Brett A. King, MD, PhD
Assistant Professor Department of Dermatology
School of Medicine
Yale University
New Haven, CT 06520

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Recent advances in the understanding of the pathogenesis of alopecia areata (AA) have yielded Janus kinase (JAK) inhibitors as a promising therapy. Short-term treatment with the JAK inhibitor, tofacitinib, has shown efficacy for severe AA, alopecia totalis (AT), and alopecia universalis (AU), but long-term data are lacking.

In this retrospective series of patients aged 18 years or older treated with tofacitinib, of 65 potential responders to therapy, defined as those with AT or AU with duration of current episode of disease of 10 years or less or AA, 77% achieved at least some hair regrowth, with 58% of patients achieving greater than 50% change in SALT score and 20% of patients achieving complete scalp hair regrowth over 4 to 18 months of treatment. Tofacitinib was well tolerated, and there were no serious adverse events.

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Electronic Prescriptions More Likely To Be Filled By Patients

MedicalResearch.com Interview with:

Adewole S. Adamson, MD, MPP Department of Dermatology The University of North Carolina at Chapel Hill Chapel Hill, NC

Dr.Adewole S. Adamson

Adewole S. Adamson, MD, MPP
Department of Dermatology
The University of North Carolina at Chapel Hill
Chapel Hill, NC

MedicalResearch.com: What is the background for this study?

Response: As the United States has moved to increasing levels of electronic medical record keeping, electronic prescribing has become an important part of improving the quality of care and patient experience. E-prescribing increases co-ordination between pharmacist and physician and decreases prescription errors. However, it is less certain whether e-prescribing affects patient primary adherence to medications, meaning whether or not a patient will fill and pick up their medication at the pharmacy. Although it may seem intuitive that primary adherence would increase by removing the patient from the prescription-to-pharmacy routing process, there have been few studies directly comparing primary adherence of patients given traditional paper prescriptions versus e-prescriptions.

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